Endoscopic Ultrasound-Guided Pancreatic Duct Drainage

Endoscopic ultrasound-guided pancreatic duct drainage (EUS-PDD) is a method of decompressing the pancreatic duct (PD) if unable to access the papilla or surgical anastomosis, particularly in nonsurgical candidates. The 2 types of EUS-PDD are EUS-assisted pancreatic rendezvous (EUS-PRV) and EUS-guided pancreaticogastrostomy (EUS-PG). EUS-PRV should be considered in patients with accessible papilla or anastomosis, while EUS-PG is a comparable alternative in surgically altered foregut anatomy. While technical and clinical successes range from 79% to 100%, adverse events occur in approximately 20%. A multidisciplinary approach that considers the patient's anatomy, clinical indication, and long-term goals should be discussed with surgical and interventional radiology colleagues.